Moderate to severe knee instability
Significant bone loss and/or ligament deficiencies caused by neoplasms, trauma, rheumatoid arthritis, osteoarthritis, traumatic arthritis, collagen disorders, and/or avascular necrosis of the proximal and/or distal femur and/or proximal tibia.
Valgus, varus or flexion deformities
The salvage of previously failed surgical attempts
A total femoral replacement construct consisting of the MOST Options® or Segmental proximal femoral, Segmental System segments and Segmental System distal femoral components may be used without cement.
Variable Stiffness stem extensions require the use of either a smooth or Trabecular Metal stem collar, which must be cemented to the stem. Following cementing to the stem, the smooth collar must be cemented against the bone. The remainder of the stem must be used uncemented.
Fluted stem extensions require the use of either a smooth or Trabecular Metal stem collar, which must be cemented to the stem. Following cementing to the stem extension, the smooth collar must be cemented against the bone. The remainder of the stem must also be cemented against the bone.
The Trabecular Metal collar may be used cemented or uncemented against the bone.
All other constructs are for cemented use only.

Device Description

The Zimmer Segmental System is intended to replace the proximal femur, mid-shaft femur, distal femur, proximal tibia and/or total knee in cases that require extensive resection and restoration. The Segmental System provides for cross compatibility between selected components from the MOST Options® System and NexGen® Rotating Hinge Knee System. A total mid-calf to hip replacement can be achieved using the Segmental System. The cleared distal femoral component and the proposed proximal tibial component are designed to be compatible with standard NexGen patella components. The proximal femoral components are designed to be compatible with various Zimmer femoral heads with a 12/14 taper.

The Trabecular Metal Proximal Femoral Component is designed to replace the proximal femur and is available in two sizes (38mm and 46mm offsets). The Trabecular Metal Proximal Tibial Component is designed to replace the proximal tibia and is available in three sizes. The Segment with Male/Female Taper components are designed to be used with Segmental System Stem Extensions in combination with a proximal femoral component, a distal femoral component, and/or a proximal tibial component, or intercalary segments, in order to replace portions of the proximal femur, mid-shaft femur, distal femur, and/or proximal tibia.

AI/ML Overview

Here's an analysis of the provided text regarding the acceptance criteria and study for the Zimmer Segmental System Trabecular Metal components:

1. Table of Acceptance Criteria and Reported Device Performance

Acceptance Criterion	Reported Device Performance
Equivalence to Predicate Devices (Intended use, materials, sterility, performance characteristics)	"The proposed Segmental System components are similar or identical in intended use, materials, sterility, and performance characteristics to the predicate devices."
Safety and Effectiveness	"The results of non-clinical (lab) performance testing demonstrate that the devices are safe and effective and substantially equivalent to the predicate devices."
Proximal Femoral Component Fatigue Test	Successful (implied by "demonstrate that the devices are safe and effective and substantially equivalent")
Proximal Tibial Component Fatigue Test	Successful (implied by "demonstrate that the devices are safe and effective and substantially equivalent")
Segment Component Fatigue Test	Successful (implied by "demonstrate that the devices are safe and effective and substantially equivalent")

2. Sample Size Used for the Test Set and Data Provenance

Test Set Sample Size: Not specified. The document states "Non-Clinical Performance and Conclusions: The results of non-clinical (lab) performance testing demonstrate..."
Data Provenance: The testing was "non-clinical (lab) performance testing." The country of origin is not explicitly stated, but the sponsor is Zimmer, Inc.
- Retrospective or Prospective: Not applicable as it's non-clinical lab testing.

3. Number of Experts Used to Establish Ground Truth for the Test Set and Qualifications

This information is not applicable. The study described is non-clinical (lab) performance testing and does not involve human expert ground truth for medical imaging or diagnostics. It assesses the mechanical performance of the device.

4. Adjudication Method for the Test Set

Not applicable as the study involves non-clinical lab testing, not human-based adjudication.

5. If a Multi-Reader Multi-Case (MRMC) Comparative Effectiveness Study Was Done

No. An MRMC study was not done. The document explicitly states: "Clinical data and conclusions were not needed for this device." This type of study typically involves human readers a device (like AI) against human performance.

6. If a Standalone (Algorithm Only Without Human-in-the-Loop Performance) Study Was Done

Not applicable. This device is a medical implant (prosthesis components), not an algorithm or AI software. Therefore, the concept of a "standalone" algorithmic performance study does not apply. The performance evaluated is the mechanical performance of the physical device itself.

7. The Type of Ground Truth Used

The "ground truth" for this non-clinical testing would be the engineering specifications and scientific principles governing mechanical fatigue and material properties relevant to the intended use of the prosthetic components. The tests verify that the device meets these pre-defined engineering standards.

8. The Sample Size for the Training Set

Not applicable. This device is hardware, not an AI algorithm. There is no concept of a "training set" in this context.

9. How the Ground Truth for the Training Set Was Established

Not applicable. As above, there is no training set for this hardware device.

Summary of the Study:

The study described is focused on demonstrating substantial equivalence of the Zimmer Segmental System Trabecular Metal components to predicate devices through non-clinical (lab) performance testing. The specific tests mentioned are:

Proximal femoral component fatigue test
Proximal tibial component fatigue test
Segment component fatigue test

The conclusion drawn from these tests is that the devices are safe and effective and substantially equivalent to the predicate devices. No clinical data or human reader studies were deemed necessary for this 510(k) clearance.

Summary

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Image /page/0/Picture/0 description: The image contains a logo and some handwritten text. The logo is a circle with a stylized letter "Z" inside, and below it, the word "zimmer" is printed in a bold, sans-serif font. To the left of the logo, there is handwritten text that appears to be "K110940" and "p.1/4".

JUL - 1 2011

Summary of Safety and Effectiveness

Sponsor:	Zimmer, Inc.P.O. Box 708Warsaw, IN 46581-0708
Contact Person:	Mark D. WarnerSpecialist, Regulatory AffairsTelephone: 574-372-4150Fax: (574) 372-4605
Date:	April 1, 2011
Trade Name:	Zimmer® Segmental System Trabecular Metal™Proximal Tibial Component, Trabecular MetalProximal Femoral Component, and additionalSegment with Male/Female Taper components
Common Name:	Total Hip Prosthesis (proximal femoral component,segment components)
	Total Knee Prosthesis (proximal tibial component,segment components)
Classification Name and Reference:	LPH - Prosthesis, Hip, Semi-Constrained,Metal/Polymer, Porous Uncemented;21 CFR § 888.3358
	LWJ - Prosthesis Hip, Semi-Constrained,Metal/Polymer, Uncemented; 21 CFR § 888.3360
	JDI - Prosthesis, Hip, Semi-Constrained,Metal/Polymer, Cemented; 21 CFR § 888.3350
	LZO - Prosthesis, Hip, Semi-Constrained,Metal/Ceramic/Polymer, Cemented or Non-Porous,Uncemented; 21 CFR § 888.3353
	KWY - Prosthesis, Hip, Hemi-, Femoral,Metal/Polymer, Cemented or Uncemented;21 CFR § 888.3390

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110940 $ 2/4

Predicate Devices:

Device Description:

KWL - Prosthesis, Hip, Hemi-, Femoral, Metal; 21 CFR § 888.3360

KWZ - Prosthesis, Hip, Constrained, Cemented or Uncemented, Metal/Polymer; 21 CFR § 888.3310

KRO - Prosthesis, Knee, Femorotibial, Constrained, Cemented, Metal/Polymer; 21 CFR & 888.3510

Zimmer Segmental System, manufactured by Zimmer Inc. (K070978, cleared July 3, 2007)

Zimmer Segmental System Proximal Femoral Component, manufactured by Zimmer Inc. (K101296, cleared July 30, 2010)

MOST System, manufactured Intermedics Orthopedics, Inc. (K964350, cleared January 16, 1997)

MOST Options System, manufactured Sulzer Orthopaedics (K013031, cleared December 7, 2001)

NexGen® Complete Knee Solutions Rotating Hinge Knee System, manufactured by Zimmer, Inc. (K013385, cleared January 9, 2002)

The Trabecular Metal Proximal Femoral Component is designed to replace the proximal femur and is available in two sizes (38mm and

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K110940 08/4

Intended Use:

46mm offsets). The Trabecular Metal Proximal Tibial Component is designed to replace the proximal tibia and is available in three sizes. The Segment with Male/Female Taper components are designed to be used with Segmental System Stem Extensions in combination with a proximal femoral component, a distal femoral component, and/or a proximal tibial component, or intercalary segments, in order to replace portions of the proximal femur, mid-shaft femur, distal femur, and/or proximal tibia.

This Segmental System is indicated for:

। Significant bone loss and/or ligament deficiencies caused by neoplasms, trauma, rheumatoid arthritis, osteoarthritis, traumatic arthritis, polyarthritis, collagen disorders, and/or avascular necrosis of the proximal and/or distal femur and/or proximal tibia
Valgus, varus or flexion deformities ।
। The salvage of previously failed surgical attempts
A total femoral replacement construct consisting . of the MOST Options or Segmental proximal femoral, Segmental System segments and Segmental System distal femoral components may be used without cement.
Variable Stiffness stem extensions require the . use of either a smooth or Trabecular Metal stem collar, which must be cemented to the stem. Following cementing to the stem, the smooth collar must be cemented against the bone. The remainder of the stem must be used uncemented.
. Fluted stem extensions require the use of either a smooth or Trabecular Metal stem collar, which must be cemented to the stem. Following cementing to the stem extension, the smooth collar must be cemented against the bone. The remainder of the stem must also be cemented against the bone.
The Trabecular Metal collar may be used . cemented or uncemented against the bone.
All other constructs are for cemented use only. .

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Comparison to Predicate Device:

K110940
p4/4

Performance Data (Nonclinical and/or Clinical):

The proposed Segmental System components are similar or identical in intended use, materials, sterility, and performance characteristics to the predicate devices.

Non-Clinical Performance and Conclusions:

The results of non-clinical (lab) performance testing demonstrate that the devices are safe and effective and substantially equivalent to the predicate devices. Performance testing included: proximal femoral component fatigue test, proximal tibial component fatigue test, segment component fatigue test.

Clinical Performance and Conclusions:

Clinical data and conclusions were not needed for this device.

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Image /page/4/Picture/1 description: The image shows the logo for the Department of Health & Human Services - USA. The logo consists of a stylized image of an eagle with its wings spread, and the text "DEPARTMENT OF HEALTH & HUMAN SERVICES - USA" is arranged in a circle around the eagle. The eagle is drawn with thick, black lines, and the text is in a simple, sans-serif font.

Food and Drug Administration 10903 New Hamoshire Avenue Document Control Room -WO66-G609 Silver Spring, MD 20993-0002

Zimmer, Inc. % Mr. Mark D. Warner Specialist, Regulatory Affairs P.O. Box 708 Warsaw, Indiana 46581-0708

JUL - 1 2011

Re: K110940

Trade/Device Name: Zimmer Segmental System Trabecular Metal Proximal Tibial Component. Trabecular Metal Proximal Femoral Component, and additional sizes of Male-Female Segments

Regulation Number: 21 CFR 888.3510 Regulation Name: Knee joint femorotibial metal/polymer constrained cemented prosthesis Regulatory Class: II Product Codes: KRO: LZO, JDI, LPH, LWJ, KWZ, KWL, KWY Dated: April 1, 2011 Received: April 4, 2011

Dear Mr. Warner:

We have reviewed your Section 510(k) premarket notification of intent to market the device referenced above and have determined the device is substantially equivalent (for the indications for use stated in the enclosure) to legally marketed predicate devices marketed in interstate commerce prior to May 28, 1976, the enactment date of the Medical Device Amendments, or to devices that have been reclassified in accordance with the provisions of the Federal Food, Drug, and Cosmetic Act (Act) that do not require approval of a premarket approval application (PMA), You may, therefore, market the device, subject to the general controls provisions of the Act. The general controls provisions of the Act include requirements for annual registration, listing of devices, good manufacturing practice, labeling, and prohibitions against misbranding and adulteration. Please note: CDRH does not evaluate information related to contract liability warranties. We remind you, however, that device labeling must be truthful and not misleading.

If your device is classified (see above) into either class II (Special Controls) or class III (PMA), it may be subject to additional controls. Existing major regulations affecting your device can be found in the Code of Federal Regulations, Title 21, Parts 800 to 898. In addition, FDA may publish further announcements concerning your device in the Federal Register.

Please be advised that FDA's issuance of a substantial equivalence determination does not mean that FDA has made a determination that your device complies with other requirements of the Act or any Federal statutes and regulations administered by other Federal agencies. You must comply with all the Act's requirements, including, but not limited to: registration and listing (21

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Page 2 – Mr. Mark D. Warner

CFR Part 807): labeling (21 CFR Part 801); medical device reporting (reporting of medical device-related adverse events) (21 CFR 803); good manufacturing practice requirements as set forth in the quality systems (QS) regulation (21 CFR Part 820); and if applicable, the electronic product radiation control provisions (Sections 531-542 of the Act); 21 CFR 1000-1050.

If you desire specific advice for your device on our labeling regulation (21 CFR Part 801), please go to http://www.fda.gov/AboutFDA/CentersOffices/CDRH/CDRHOffices/ucm115809.htm for the Center for Devices and Radiological Health's (CDRH's) Office of Compliance. Also, please note the regulation entitled, "Misbranding by reference to premarket notification" (21 CFR Part 807.97). For questions regarding the reporting of adverse events under the MDR regulation (21 CFR Part 803), please go to

http://www.fda.gov/MedicalDevices/Safety/ReportaProblem/default.htm for the CDRH's Office of Surveillance and Biometrics/Division of Postmarket Surveillance.

You may obtain other general information on your responsibilities under the Act from the Division of Small Manufacturers, International and Consumer Assistance at its toll-free number (800) 638-2041 or (301) 796-7100 or at its Internet address

http://www.fda.gov/MedicalDevices/Resourcesfor You/Industry/default.htm.

Sincerely yours,

E.J. Keith

Fr Mark N. Melkerson Director Division of Surgical, Orthopedic and Restorative Devices Office of Device Evaluation Center for Devices and Radiological Health

Enclosure

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Indications for Use

KI10940

510(k) Number (if known):

Device Name:

Zimmer Segmental System Trabecular Metal Proximal Tibial Component, Trabecular Metal Proximal Femoral Component, and additional Segment with Male/Female Taper components

Indications for Use:

· This device is indicated for:
- Moderate to severe knee instability ເ
- Significant bone loss and/or ligament deficiencies caused by neoplasms, trauma, । rheumatoid arthritis, osteoarthritis, traumatic arthritis, collagen disorders, and/or avascular necrosis of the proximal and/or distal femur and/or proximal tibia.
- Valgus, varus or flexion deformities -
- । The salvage of previously failed surgical attempts
· A total femoral replacement construct consisting of the MOST Options® or Segmental proximal femoral, Segmental System segments and Segmental System distal femoral components may be used without cement.
· Variable Stiffness stem extensions require the use of either a smooth or Trabecular Metal stem collar, which must be cemented to the stem. Following cementing to the stem, the smooth collar must be cemented against the bone. The remainder of the stem must be used uncemented.
· Fluted stem extensions require the use of either a smooth or Trabecular Metal stem collar, which must be cemented to the stem. Following cementing to the stem extension, the smooth collar must be cemented against the bone. The remainder of the stem must also be cemented against the bone.
· The Trabecular Metal collar may be used cemented or uncemented against the bone.
· All other constructs are for cemented use only.

Prescription Use X (Part 21 CFR 801 Subpart D) AND/OR

Over-The-Counter Use (21 CFR 807 Subpart C)

। ર

(Please do not write below this line -- Continue on another page if needed)

Concurrence of CDRH, Office of Device Evaluation (ODE)

	for M. Melkeron	Page 1 of 1
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(Division Sign-Off)
Division of Surgical, Orthopedic,
and Restorative Devices

510(k) Number	K110940
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Regulation Number and Section

§ 888.3510 Knee joint femorotibial metal/polymer constrained cemented prosthesis.

(a)
Identification. A knee joint femorotibial metal/polymer constrained cemented prosthesis is a device intended to be implanted to replace part of a knee joint. The device limits translation or rotation in one or more planes and has components that are linked together or affined. This generic type of device includes prostheses composed of a ball-and-socket joint located between a stemmed femoral and a stemmed tibial component and a runner and track joint between each pair of femoral and tibial condyles. The ball-and-socket joint is composed of a ball at the head of a column rising from the stemmed tibial component. The ball, the column, the tibial plateau, and the stem for fixation of the tibial component are made of an alloy, such as cobalt-chromium-molybdenum. The ball of the tibial component is held within the socket of the femoral component by the femoral component's flat outer surface. The flat outer surface of the tibial component abuts both a reciprocal flat surface within the cavity of the femoral component and flanges on the femoral component designed to prevent distal displacement. The stem of the femoral component is made of an alloy, such as cobalt-chromium-molybdenum, but the socket of the component is made of ultra-high molecular weight polyethylene. The femoral component has metallic runners which align with the ultra-high molecular weight polyethylene tracks that press-fit into the metallic tibial component. The generic class also includes devices whose upper and lower components are linked with a solid bolt passing through a journal bearing of greater radius, permitting some rotation in the transverse plane, a minimal arc of abduction/adduction. This generic type of device is limited to those prostheses intended for use with bone cement (§ 888.3027).(b)
Classification. Class II.